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Since Parodi's initial experience in 1990, the need to have appropriate vascular access to deliver the aortic stent graft in endovascular aortic repair has always represented a main issue. The continuous search for an endograft with a smaller profile with no compromise on performance and durability of the device has brought to the production of "ultra-low profile" devices, which however still remain a therapeutic challenge. This latest generation of ultra-low profile endografts currently allows the treatment of abdominal aortic diseases in patients who have previously been excluded because of challenging aortic anatomies and small access vessels. One of these grafts is the TriVascular Ovation system (14 F). After having received the CE Mark on September 17th 2010, this endograft has been used all over the world in well selected patients with relatively challenging necks or smaller iliac vessels. The Authors report their experience with the use of this endograft, with technical tips and tricks.